How to Avoid Your Client Being Declined for Long-Term Care Insurance

declined button on computer keyboard
Lori Gubash, CLTC, FICF
Lori Gubash, CLTC, FICF July 6, 2023

Lori leads the LTC team and acts as a liaison to ensure we are providing the best possible Long-Term Care Insurance and business development solutions for our agents and their senior clients.

Long-term care insurance (LTCI) underwriting has evolved quite a bit over the last few years. During the process of evaluating insurability, most carriers consider your client’s family history of certain conditions, their standing with their primary care physician (including complete lab work within 24 months), their management of chronic conditions, and their build and lifestyle, though each carrier underwrites medical conditions a little differently. Based on a client’s health, we can guide you to the best possible product for them.

Unfortunately, LTCI declines still happen. The average declination rate for an applicant under age 65 is approximately 20%, but this probability increases steadily with your client’s age. In fact, applicants over 70 years old are seeing a 50% or greater decline rate. LTCI policies are declined for a multitude of reasons. Here are a few tips to reduce the chance that your client will be declined LTCI coverage.

Read More: How to Start the Long-Term Care Planning Conversation with Clients

Pre-Qualification for LTCI

Great news: your client is interested in learning more about long-term care insurance! Now, where should you start? Before you discuss pricing with your client, you should ensure they meet the minimum underwriting requirements for LTCI. To do so, gather as much information as possible about their health history. We encourage you to use our prequalification tool here.

LTCI Application Evaluation

Now that you know your client meets the minimum underwriting requirements and you have proposed an LTCI solution that addresses their concerns, your next step is to complete an application with the carrier. It’s important for your client to answer the application questions truthfully and thoroughly. For clients with a complex health history, you may want to include a cover letter detailing the management of their condition, their lifestyle, and employment obligations. Remember, the carrier underwriter has not met your client, so any additional information you provide might help a case that could otherwise be on the fence.

Before submitting the application to the carrier’s underwriting, allow our team to review it for completeness and any medical red flags. They will contact you with any concerns.

Carrier Underwriting for LTCI

After your client’s application is submitted for underwriting, depending on the carrier and age of the client, your client may be required to complete a phone interview or a face-to-face interview. For these interviews, it’s important for the client to be prepared. They should have all their prescription drug medications handy, along with doctors’ names, phone numbers, and addresses. Each carrier usually has a form that can be completed to assist your client with their interview. Feel free to request a copy from our team at [email protected]. As part of the interview process, your client may also be required to complete a cognitive screening, which typically consists of word recall and other tools to assess whether your client is impaired. Most clients complete this assessment without any trouble, so while it’s not something your client should worry about, they should take it seriously and complete the assessment to the best of their ability.

If you have any questions about qualifying for LTCI or carrier underwriting, or if you want to discuss a specific case, please contact our office at (800) 255-1932.